Individual
MRS. COLLEEN MARIE HALLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4216 BALLOON PARK RD NE, ALBUQUERQUE, NM 87109-5801
(505) 344-5470
Mailing address
1669 LARK SPUR DR NE, RIO RANCHO, NM 87144-6534
(505) 250-9536
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
672
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68762
—
NM
Enumeration date
04/18/2007
Last updated
07/08/2007
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